[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 5267 Introduced in Senate (IS)]

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119th CONGRESS
  2d Session
                                S. 5267

To amend title XI of the Social Security Act to require the Center for 
  Medicare and Medicaid Innovation to test a model to reduce chronic 
           diseases by using Accountable Produce is Medicine.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             August 5, 2026

 Mr. Banks (for himself, Mr. Padilla, and Mr. Marshall) introduced the 
 following bill; which was read twice and referred to the Committee on 
                                Finance

_______________________________________________________________________

                                 A BILL


 
To amend title XI of the Social Security Act to require the Center for 
  Medicare and Medicaid Innovation to test a model to reduce chronic 
           diseases by using Accountable Produce is Medicine.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Accountable Produce is Medicine Act 
of 2026''.

SEC. 2. SENSE OF CONGRESS.

    It is the sense of Congress that--
            (1) diet-related chronic diseases are a leading driver of 
        health care costs in the United States;
            (2) evidence-based food-is-medicine interventions, 
        including medically tailored meals, medically tailored 
        groceries, produce prescriptions, and nutrition counseling, 
        have the potential to improve health outcomes and reduce health 
        care expenditures;
            (3) the Center for Medicare and Medicaid Innovation should, 
        to the extent practicable, incorporate such interventions, as 
        appropriate, into models tested under section 1115A of the 
        Social Security Act (42 U.S.C. 1315a); and
            (4) incorporating food-is-medicine interventions into the 
        Center for Medicare and Medicaid Innovation models may improve 
        quality of care, reduce costs, and support the prevention and 
        management of chronic disease.

SEC. 3. REQUIRING THE CENTER FOR MEDICARE AND MEDICAID INNOVATION TO 
              TEST A MODEL TO IMPROVE OUTCOMES FOR PATIENTS WITH 
              CHRONIC DISEASES BY USING ACCOUNTABLE PRODUCE IS 
              MEDICINE.

    Section 1115A of the Social Security Act (42 U.S.C. 1315a) is 
amended--
            (1) in subsection (b)(2)(A), in the third sentence, by 
        inserting ``, and, beginning not later than the date that is 
        180 days after the enactment of the Accountable Produce is 
        Medicine Act of 2026, shall include the Accountable Produce is 
        Medicine Bundled Payment Model described in subsection (h)'' 
        before the period at the end; and
            (2) by adding at the end the following new subsection:
    ``(h) Accountable Produce Is Medicine Bundled Payment Model.--
            ``(1) In general.--For purposes of subsection (b)(2)(A), 
        the Accountable Produce is Medicine Bundled Payment Model (in 
        this subsection, referred to as the `model') described in this 
        subsection is a model under which a bundled payment is made 
        under title XVIII, title XIX, or title XXI, as appropriate, for 
        selected programs to furnish Accountable Produce is Medicine 
        services to eligible individuals.
            ``(2) Selection of programs to participate.--
                    ``(A) Selected programs.--The Secretary shall 
                select to participate in the model at least 5 eligible 
                programs, each to participate for a period of not less 
                than 2 years, that the Secretary determines have the 
                capacity to satisfy the requirements described in 
                paragraph (3). In this subsection, each such eligible 
                program so selected shall be referred to as a `selected 
                program'.
                    ``(B) Priority.--In selecting eligible programs 
                under subparagraph (A), the Secretary shall give 
                priority to any such program that furnishes (including 
                through an arrangement with a provider of services or 
                supplier or other entity) fresh, frozen, or minimally 
                processed fruits and vegetables without added sugars, 
                sodium, or saturated fats (except those occurring 
                naturally), and other plant-based, nutrient-dense 
                foods, including nuts, seeds, intact whole grains, 
                beans, and lentils.
            ``(3) Minimum program requirements.--Under the model, a 
        selected program shall comply with each of the following 
        requirements:
                    ``(A) Screening.--The selected program shall screen 
                individuals who are referred to the program by a 
                physician, hospital, or other health care provider, to 
                determine whether such individuals are eligible 
                individuals.
                    ``(B) Accountable produce is medicine services.--In 
                the case of an individual who is determined by the 
                selected program under subparagraph (A) to be an 
                eligible individual, the selected program shall, for 
                the 1-year period following such determination (subject 
                to subparagraph (D)), make available (including through 
                an arrangement with a provider of services or supplier 
                or other entity) to such individual the following 
                services (in this subsection referred to as 
                `Accountable Produce is Medicine services' or `APIM 
                services'):
                            ``(i) A personalized health risk assessment 
                        and personalized prevention plan.
                            ``(ii) Care coordination services.
                            ``(iii) Telehealth services related to 
                        chronic disease monitoring, education, and 
                        follow-up.
                            ``(iv) Remote patient monitoring items and 
                        services that are clinically appropriate for 
                        monitoring chronic disease and facilitating a 
                        timely response from a provider in the case 
                        that the selected program detects significant 
                        changes in the data being monitored.
                            ``(v) Lifestyle modification programs, 
                        including nutrition counseling provided by a 
                        registered dietician or other qualified 
                        provider, exercise programs, and smoking 
                        cessation counseling.
                            ``(vi) Healthy, nutrient-dense foods 
                        meeting such standards as the Secretary shall 
                        determine, with preference given to produce 
                        grown within 250 miles of the selected program 
                        or through the use of regenerative agriculture.
                    ``(C) Collection of health data; reenrollment 
                assessment.--In the case of an individual who is 
                determined by the selected program under subparagraph 
                (A) to be an eligible individual, the selected program 
                shall--
                            ``(i) track the APIM services that the 
                        individual has received from the program under 
                        the model;
                            ``(ii) regularly evaluate the individual's 
                        engagement with the program and adherence to 
                        program requirements;
                            ``(iii) on a quarterly basis collect from 
                        such individual updated weight, blood pressure, 
                        and blood glucose measurements, and any other 
                        measurements determined appropriate by the 
                        Secretary; and
                            ``(iv) at the end of the 1-year period 
                        described in subparagraph (B)--
                                    ``(I) evaluate the measurements 
                                collected under clause (iii);
                                    ``(II) submit to the Secretary such 
                                data as the Secretary determines 
                                necessary for purposes of evaluating 
                                the health care cost savings achieved 
                                for such individual during such period; 
                                and
                                    ``(III) provide for an additional 
                                determination under subparagraph (A) as 
                                to whether such individual remains an 
                                eligible individual.
                    ``(D) Disenrollment.--In the case of an individual 
                who is determined by the selected program under 
                subparagraph (A) to be an eligible individual, if the 
                selected program determines (in accordance with 
                standards established by the Secretary) before the end 
                of the 1-year period described in subparagraph (B) that 
                such individual is not adequately engaging with the 
                program or is not adhering to program requirements, the 
                selected program shall terminate the individual's 
                participation in the program and may not furnish any 
                additional APIM services to such individual under the 
                model.
            ``(4) Payment.--
                    ``(A) In general.--The Secretary shall determine 
                the form, manner, and amount of bundled payment to be 
                provided to selected programs under the model and, 
                beginning in the third year in which such model is 
                carried out, may require that selected programs assume 
                financial risk for performance under the model.
                    ``(B) Cost sharing.--APIM services furnished by a 
                selected program to an eligible individual shall be 
                provided without application of deductibles, 
                copayments, coinsurance, or other cost-sharing under 
                the applicable title.
            ``(5) Duration.--The model shall be carried out for a 
        period of not less than 5 years.
            ``(6) Definitions.--In this subsection:
                    ``(A) Eligible individual.--The term `eligible 
                individual' means an individual--
                            ``(i) who is--
                                    ``(I) entitled to benefits under 
                                part A of title XVIII or enrolled for 
                                benefits under part B of such title;
                                    ``(II) enrolled under a State plan 
                                (or waiver of such plan) under title 
                                XIX; or
                                    ``(III) enrolled under a State 
                                child health plan (or waiver of such 
                                plan) under title XXI;
                            ``(ii) who resides in a medically 
                        underserved area (as designated pursuant to 
                        section 330(b)(3)(A) of the Public Health 
                        Service Act), a rural area (as defined in 
                        section 1886(d)(2)(D)), a health professional 
                        shortage area described in section 332(a)(1)(A) 
                        of the Public Health Service Act, or another 
                        area determined appropriate by the Secretary;
                            ``(iii) who has diabetes, obesity, 
                        cardiovascular disease, hypertension, 
                        malnutrition, or any other disease or chronic 
                        condition that the Secretary determines 
                        appropriate;
                            ``(iv) in the clinical judgment of a 
                        physician or other health care professional, 
                        who would benefit from participation in the 
                        model;
                            ``(v) who the eligible program determines 
                        to be prepared to participate in the model; and
                            ``(vi) who is not already receiving items 
                        or services that the Secretary determines are 
                        substantially similar (and duplicative in 
                        purpose and clinical function) to the APIM 
                        services described in clause (v) of paragraph 
                        (3)(B).
                    ``(B) Eligible program.--The term `eligible 
                program' means a provider of services (as defined in 
                section 1861(u)) or supplier enrolled in the program 
                under title XVIII, title XIX, or title XXI.
                    ``(C) Regenerative agriculture.--The term 
                `regenerative agriculture' means a conservation 
                management approach that emphasizes natural resources 
                through improved soil health, water management, and 
                natural vitality.
                    ``(D) Supplier.--The term `supplier' means a 
                physician or other practitioner, a facility, or other 
                entity that furnishes services under title XVIII, title 
                XIX, or title XXI.''.
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